Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

Cancer is a leading cause of mortality in children and results in a significant disease burden. Lipid metabolic reprogramming emerges as a pivotal cancer hallmark, bearing profound implications for understanding tumorigenesis, developing treatment strategies, and improving prognoses. However, research on lipid metabolism and lipid nutritional interventions related to childhood cancers is notably limited compared to adult cancers. This review focused on the current understanding of fatty acid, cholesterol, and phospholipid metabolism in childhood cancers and discussed the correlation between major lipid dietary patterns (such as high-fat, ketogenic, and Mediterranean diets) and the development and progression of childhood cancers. This review also highlighted existing research gaps on the mechanisms of lipid metabolism and the effects of major lipid dietary patterns, and warranted improved research depth, experimental design, and sample size. Therefore, we advocate for future epidemiological, basic science, and multidisciplinary research in the field of childhood cancers to understand more comprehensively and profoundly the role of lipid nutrition in the prevention and treatment of pediatric cancers.

In 2023, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the " Notice on carrying out the theme activity to improve medical experience and enhance patient experience", China has entered a new stage of development in the field of medical service improvement. This study, through literature research, sorted out the evolution of China′s patient medical experience-related policies and the shift in concept from satisfaction to medical experience. It divided the historical evolution of patient medical experience policies into four periods: the exploration period, the development period, the policy improvement period, and the new policy implementation period, based on the implementation of reform and opening up, the introduction of new medical reforms, and the proposal of the " theme activity" in 2023. From May to August 2023, interviews were conducted with 20 experts in the field of health management, 20 clinical doctors, and 20 inpatients to discuss China′s experience, deficiencies, and suggestions for improving patient medical experience. Based on the interview materials, this study summarized China′s experience and deficiencies in enhancing patient medical experience from aspects such as resources, systems, concepts, and human resources. It suggested adjusting the structure and layout of medical resources to enhance the balance of high-quality medical resource allocation; establishing a comprehensive evaluation system for patient medical experience; increasing the attention and conceptual understanding of health administrative departments and medical institutions at all levels to optimize patient medical experience, and improving the formulation and connection of supporting policies; caring for medical staff and fully mobilizing their initiative to enhance patient experience, in order to continuously improve patient medical experience.

Objective:To analyze the factors influencing patients′ medical experience, to provide reference for medical institutions to improve patients′ medical experience.Methods:A stratified sampling method was employed nationwide to select 32 patients and 20 medical staff. From May to August 2023, semi-structured interviews were conducted with them regarding the factors influencing patients′ medical experience. The data from the interviews were analyzed using programmed grounded theory, which led to the identification of factors affecting patients′ medical experience.Results:After three-level coding, four main categories of demographic characteristics, self health characteristics, medical outcome experience, and medical process experience, two core categories of patient related influencing factors and hospital related influencing factors were obtained. Additionally were also obtained.Conclusions:The factors influencing patients′ medical experience are multifaceted and jointly dominated by multiple stakeholders. Medical institutions should adopt a variety of measures to continuously improve patients′ medical experience. When assessing patients′ medical experience, the impact of individual differences among patients on the assessment results should be fully considered.

In 2023, the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the " Notice on carrying out the theme activity to improve medical experience and enhance patient experience", China has entered a new stage of development in the field of medical service improvement. This study, through literature research, sorted out the evolution of China′s patient medical experience-related policies and the shift in concept from satisfaction to medical experience. It divided the historical evolution of patient medical experience policies into four periods: the exploration period, the development period, the policy improvement period, and the new policy implementation period, based on the implementation of reform and opening up, the introduction of new medical reforms, and the proposal of the " theme activity" in 2023. From May to August 2023, interviews were conducted with 20 experts in the field of health management, 20 clinical doctors, and 20 inpatients to discuss China′s experience, deficiencies, and suggestions for improving patient medical experience. Based on the interview materials, this study summarized China′s experience and deficiencies in enhancing patient medical experience from aspects such as resources, systems, concepts, and human resources. It suggested adjusting the structure and layout of medical resources to enhance the balance of high-quality medical resource allocation; establishing a comprehensive evaluation system for patient medical experience; increasing the attention and conceptual understanding of health administrative departments and medical institutions at all levels to optimize patient medical experience, and improving the formulation and connection of supporting policies; caring for medical staff and fully mobilizing their initiative to enhance patient experience, in order to continuously improve patient medical experience.

Objective:To analyze the factors influencing patients′ medical experience, to provide reference for medical institutions to improve patients′ medical experience.Methods:A stratified sampling method was employed nationwide to select 32 patients and 20 medical staff. From May to August 2023, semi-structured interviews were conducted with them regarding the factors influencing patients′ medical experience. The data from the interviews were analyzed using programmed grounded theory, which led to the identification of factors affecting patients′ medical experience.Results:After three-level coding, four main categories of demographic characteristics, self health characteristics, medical outcome experience, and medical process experience, two core categories of patient related influencing factors and hospital related influencing factors were obtained. Additionally were also obtained.Conclusions:The factors influencing patients′ medical experience are multifaceted and jointly dominated by multiple stakeholders. Medical institutions should adopt a variety of measures to continuously improve patients′ medical experience. When assessing patients′ medical experience, the impact of individual differences among patients on the assessment results should be fully considered.

Objective:To investigate the effect of cyclin A1 on the invasion, metastasis, and prognosis of hepatocellular carcinoma (HCC).Methods:Immunohistochemistry (IHC) was used to detect the expressional condition of cyclin A1 in HCC and paraffin-embedded non-tumor adjacent tissues. Kaplan-Meier method was used for the survival analysis of patients with HCC. Western blot (WB) was used to detect the expression of cyclin A1 in HCCLM3 and QGY-7703 cells. Scratch wound healing assay, transwell migration, and invasion assay were used to detect the effect of cyclin A1 overexpression on cell migration and invasion ability. WB was used to detect changes in the expression of matrix metalloproteinase (MMP) 2, MMP9, and vascular endothelial growth factor (VEGF) after overexpression of cyclin A1. Measurement data were compared using a t-test and analysis of variance. Count data was measured using χ2 test and the Log-rank method was performed for survival analysis. Results:Cyclin A1 expression rates were higher in the tissues of HCC patients with recurrent metastasis than in the tissues of patients without recurrent metastasis (60.42% vs. 46.81%, χ2 = 4.711, P < 0.05). The overall postoperative survival time (OS) and disease-free survival (DFS) were shorter in patients with high cyclin A1 expression than those with low cyclin A1 expression (45.9 months vs. 53.1 months; 42.9 months vs. 51.3 months, and P < 0.01). The postoperative OS and DFS were shorter in patients with high cyclin A1 expression and recurrent metastasis than those with low cyclin A1 expression without recurrent metastasis (31.7 months vs. 43.9 months; 18.0 months vs. 31.5 months, and P < 0.05). HCCLM3 and QGY-7703 cells were higher in the cyclin A1-pEX group than in the empty vector (vector) group (1.56 ± 0.06 vs. 0.18 ± 0.01, t = 18.75, P < 0.001; 1.31 ± 0.05 vs.0.37 ± 0.02, t = 15.17, P < 0.001). The migrated distances of HCCLM3 cells in the cyclin A1-pEX group and the vector group were (536.7 ± 14.5) μm and (327.3 ± 9.3) μm, t = 11.84, P < 0.05, respectively, while the migrated distances of QGY-7703 cells in the two groups were (916.7 ± 35.3) μm and (320.0 ± 20.8) μm, t = 13.54, P < 0.01. The migrated numbers of HCCLM3 cells in the cyclin A1-pEX group and vector group were (37.3 ± 2.4) and (7.0 ± 1.2), t = 12.67, P < 0.001, and the number of invasive cells was (73.7 ± 4.1) and (12.6 ± 1.5), t = 12.36, P < 0.001, respectively. The migrated numbers of QGY-7703 cells in the two groups were (153.3 ± 6.0) and (17.7 ± 3.7), t = 17.59, P < 0.001, and the number of invasive cells was (45.0 ± 2.9) and (9.3 ± 1.5), t = 10.66, P < 0.001, respectively. The expression levels of MMP2, MMP9, and VEGF in HCCLM3 and QGY-7703 cells were significantly higher in the cyclin A1-pEX group than those in the vector group ( P < 0.05). Conclusion:Cyclin A1 plays an important role in HCC invasion and metastasis, but HCC patients with high cyclin A1 expression have a poor prognosis. Hence, cyclin A1 has high guiding significance for evaluating patient prognosis.

Background: Chronic functional constipation is a common functional gastrointestinal disorder, and the effects of traditional therapeutic drugs are suboptimal. Prucalopride is a novel 5-HT